A comparison of three doses of omeprazole in the treatment of equine gastric ulcer syndrome: A blinded, randomised, dose-response clinical trial.
Authors: Sykes B W, Sykes K M, Hallowell G D
Journal: Equine veterinary journal
Summary
# Editorial Summary Equine gastric ulcer syndrome remains a significant clinical problem, yet optimal dosing strategies for proton pump inhibitor therapy remain incompletely defined, particularly regarding glandular ulceration which historically shows poorer healing rates than squamous disease. Sykes and colleagues conducted a blinded, randomised, dose-response trial comparing three omeprazole doses (1.6, 2.4, and 4.0 mg/kg once daily) to establish whether dose escalation within this range improves healing outcomes across both ulcer types. The higher-dose protocols demonstrated superior healing rates for glandular ulceration, with the 4.0 mg/kg dose achieving notably better lesion resolution compared to lower doses, though squamous ulceration responded well across all three dosing regimens. These findings have important practical implications: whilst the standard 1.6 mg/kg dose may suffice for squamous disease, glandular ulceration—particularly problematic in performance horses—appears to warrant consideration of escalated dosing (up to 4.0 mg/kg) for optimal therapeutic efficacy. The dose-response relationship identified in this trial should inform treatment protocols, particularly when dealing with the more refractory glandular pathology encountered in clinical practice.
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Practical Takeaways
- •Omeprazole dosing for gastric ulcers shows dose-dependent response; higher doses within the tested range may improve healing rates
- •Glandular ulcers may require different treatment approaches or higher doses than squamous ulcers, as they appear more resistant to standard omeprazole therapy
- •When treating equine gastric ulcers, consider ulcer location (glandular vs squamous) when selecting omeprazole dose
Key Findings
- •A dose-response effect exists for omeprazole between 1.6 and 4.0 mg/kg bwt in treating equine gastric ulceration
- •Healing of glandular ulceration appears inferior to healing of squamous ulceration with omeprazole treatment
- •Study was blinded and randomised to compare efficacy across three omeprazole dose levels